Objective: Since 2009, the unit of smoking cessation at Sahloul University Hospital – Tunisia was founded. In this context, the objective of our study was to determine the factors associated with smoking cessation in Tunisian smokers. Methods: It was a descriptive prospective study over five-years-period 2015-2020. We included all patients who willingly came to the anti-smoking consultation of the Sahloul University hospital Sousse Tunisia. Data were collected during the consultation of all patients. We proceeded to a univariate and then multivariable analysis to identify the predictive factors of smoking cessation. Results: Over 5 years, we included 450 patients, mainly males (91.3%). The average age of the consultants was 46 ±15.58 years. The average age of the first cigarette among our patients was 16.83± 4.34 years. The likelihood of smoking cessation was higher among males (p=0.004, OR=9.708), patients attending minimum 3 anti-smoking consultations (p<10-3, OR=5.714), patients benefiting from nicotine replacement therapy (p=0.034, OR=2.123), with high motivation score for smoking cessation (p=0.001, OR=1.980) and with an advanced age of the first cigarette (p<10-3, OR=1.096). However, the likelihood of smoking cessation was lower among coffee and alcohol consumers (p=0.002, OR=0.252) and smokers with less than 5 years smoking habit (p=0.011, OR=0.069). Conclusion: Although the decision to stop smoking is a personal one, it requires medical and psychological support as highlighted by our findings. Our study showed that assiduity and medical assistance for tobacco cessation increase smokers’ chances of quitting.

AIM: To retrospectively study the therapeutic modalities of primary breast sarcomas in view of the data of a local Tunisian experience. METHODS: It is a monocentric, descriptive, retrospective study including 13 cases of primary breast sarcoma treated over a period of 25 years (1995–2020) in the oncological radiotherapy department of a university hospital in Sousse, Tunisia. RESULTS: In our study, 13 cases of non-metastatic breast sarcomas that has been identified, divided into ten cases of phyllodes sarcomas and three cases of non-phyllodes sarcomas. Surgically, all our patients had a mastectomy. Among them, seven underwent a lymph node procedure: five underwent axillary lymph node dissection, and two others had primary axillary lymph node biopsy. For the adjuvant treatment, all the patients included in our study received radiotherapy and seven received chemotherapy. Local recurrence occurred on the operative scar in one patient after completion of radiation therapy. Metastatic relapse was described in five patients. The time to onset of metastases varied between two months and five years. Nevertheless, a complete remission was noted in 6 patients with a follow-up varying from four years to 20 years. Two patients were lost to follow-up. CONCLUSION: Breast sarcomas remain a very rare entity of aggressive tumors. The therapeutic approach is poorly codified. For this reason, the therapeutic decision should always be discussed in a multidisciplinary assessment.

Introduction-Aim: Healthcare-associated infections (HCAIs) are a major public health issue due to significant related morbidity, mortality and increased costs. This study aimed to determine the prevalence of HCAI in a Tunisian university hospital in 2024 and to determine its associated factors. Methods: A point-prevalence study was conducted from 10th to 22nd of June 2024 in Habib-Bourguiba hospital in Sfax-Tunisia. It included all patients hospitalised for a minimum of 48 hours. Results: Of 227 patients, 40 patients had at least one HCAIs, giving a HCAIs prevalence of 17.6% (95%CI 12.8-22.5). The HCAIs prevalence was 46.7% (95%CI 29.2-65.4) in ICU (Intensive care units) versus 13.9% (95%CI 8.9-19.6) in non-ICU. Urinary tract infections (40.6%) were the most common, followed by respiratory tract infections and surgical site infections (both 17.4%). The main identified microorganisms among HCAIs were Pseudomonas Aeruginosa (19.3%), Klebsiella Pneumoniae and Proteus Mirabilis (both 14.8%). Factors independently associated with having at least one HCAI were admission in ICU (aOR=5.7, 95%CI: 2.4-13.3), obesity (aOR = 4.2, 95%CI: 1.5-12.1), age 60 years and older (aOR=2.7, 95%CI: 1.1-7.4), antibiotic use in the past six months (aOR = 2.5, 95%CI: 1.1-5.7), and the number of days of peripheral venous catheter (aOR = 1.6, 95%CI: 1.1-2.5). Conclusion: Our study fills a critical gap in the literature on the national and regional levels. It revealed a high prevalence of HCAI in Habib-Bourguiba Hospital compared to similar studies in other regions. We, therefore, recommend setting up operational hospital hygiene programmes for healthcare ..(abstract truncated at 250 words)

The first case of Coronavirus Disease 2019 (COVID-19) in Tunisia was reported on 2 March 2020. This study aimed to describe the epidemiological evolution of the COVID-19 pandemic in Tunisia from March 2020 to December 2022 and to assess changes in key transmission indicators across the different phases and epidemic waves. We conducted a nationwide longitudinal descriptive study based on prospectively collected surveillance data including all laboratory-confirmed COVID-19 cases reported through the national surveillance system between March 2020 and December 2022. Descriptive analyses were performed to estimate screening rates, test positivity rates, cumulative incidence rates, and the time-varying effective reproduction number (Rt). During the three-year study period, Tunisia reported a cumulative incidence of 9562.05 cases per 100,000 inhabitants. The mean daily screening rate was 38.23 tests per 100,000 inhabitants, while the average positivity rate reached 16.03%. The mean effective reproduction number was estimated at 1.14 (95% CI: 1.11–1.17). The epidemic evolved through two distinct transmission phases. The first phase, extending from 2 March to 17 August 2020, was characterized by limited community transmission mainly associated with imported cases. The second phase was marked by sustained autochthonous community transmission and comprised five epidemic waves. Between March and May 2021, genomic surveillance identified the predominance of the Alpha Variant of Concern (VOC). The fourth wave was dominated by the Delta VOC until December 2021, whereas the fifth wave, occurring in 2022, was associated with the Omicron VOC. Continuous monitoring of transmission indicators through the national surveillance system provided timely evidence to support risk assessment, guide public health decision-making, and adapt prevention and control measures throughout the different phases of the pandemic in Tunisia.

Background and Aims: Patients undergoing lower limb orthopedic surgery under spinal anesthesia often experience significant perioperative anxiety and discomfort. Virtual reality (VR) has emerged as a promising non‐pharmacological intervention for anxiety and pain management. This study aimed to investigate the efficacy of VR as a complementary method for improving perioperative anxiety and pain management in patients undergoing lower limb orthopedic surgery under spinal anesthesia. Methods: This prospective, single‐center, randomized, single‐blind trial included two groups: a VR group, receiving perioperative VR exposure, and a control group with standard care. The primary outcome was perioperative anxiety reduction measured using the State‐Trait Anxiety Inventory‐6 (STAI‐6) from preoperative period to after surgery. Secondary outcomes included pain intensity, sedative and analgesic medication consumption, hemodynamic stability, postoperative complications, and satisfaction of patients, anesthesia, and surgical teams. A total of 160 patients were randomized into 2 groups, of whom 60 per group were included in the final analysis. The trial was registered with the Pan African Clinical Trial Registry (PACTR202507660086282) and ClinicalTrials.gov (NCT07134764). Results: The VR group demonstrated significantly lower postoperative anxiety levels compared to controls, with intense anxiety occurring less frequently (25% vs. 50%, p = 0.005). STAI‐6 scores showed marked reduction in the VR group (36.5 ± 7.92 vs. 46.72 ± 2.58, p < 0.001). Midazolam consumption was significantly reduced in the VR group (20% vs. 53.3%, p = 0.001). The VR group experienced significantly fewer postoperative complications including nausea (18.3% vs. 36.7%, p = 0.025) and headache (16.7% vs. 35%, p = 0.002). Patient satisfaction was significantly higher in the VR group, with dissatisfaction rates dramatically lower (3.3%vs.43.3%, p < 0.001). Both anesthesia and surgical teams reported higher satisfaction when managing VR group patients. Conclusion: VR distraction significantly reduces perioperative anxiety, decreases sedative medication requirements, reduces postoperative nausea and headaches, and improves satisfaction.